The Progressive Democrat Newsletter grew out of the frustration of the 2004 election. Originally intended for New York City progressives, its readership is now national. For anyone who wants to be alerted by email whenever this newsletter is updated (usually weekly), please send your email address and let me know what state you live in (so I can keep track of my readership).

Friday, July 31, 2009

My Message to the Democratic Party: Get off your Asses on Healthcare Reform

Now is the time for Congress to act on Healthcare Reform. There is no reason for them to wait. And I want to send a clear message to those who I have supported in the past who seem to be hesitating: particularly Congresswoman Nydia Velasquez, Congresswoman Linda Sanchez and Congressman Zach Space, all of whom I have strongly supported in the past. But I also have a message to the Democratic leadership: my active support of the Democratic Party in general (as opposed to simply supporting individual progressive candidates) depends for now on Healthcare reform.

I was among the first to sign up for Howard Dean's Democracy Bond program. Since July 2005 I have given $20 per month to the DNC. That is four solid years of monthly contributions. Now that isn't by any means the only donations I have made to Democrats, but it felt good to be part of Dean's 50 state strategy that did so well in 2006 and 2008.

I cancelled that monthly contribution recently because I cannot believe that the Democrats I have been supporting for so long now want to go on vacation rather than actually enact precisely what America needs to begin fixing our very broken healthcare system. In essence, I will not contribute to people who think their vacation is more valuable than our health. I am also backing off on other donations that go to the Democratic Party (local, state or national) rather than individual candidates or progressive organizations.

Back when Democrats were giving in to Bush on Iraq even after it had become clear Bush had lied to get us into the war, I got fed up with House and Senate Democrats being so wimpy that I stopped donating to the DSCC and DCCC and every single phone call I got from either (about one a month) I told them I was fed up with the wimpiness of Congressional Democrats so I wasn't giving. Before that I had given hundreds of dollars a year to each. So though I wasn't a large donor, they did realize that I was a dedicated Democrat. And some callers were very understanding of my view and assured me they'd pass my concerns on to their suprevisors. But nothing ever seemed to come of it, so my donations to the DSCC and DCCC ended.

Instead, I donated to individual Democrats all around the country and to progressive organizations. Later, I focused on DFA, Progressive Majority, Wellstone Action, National Jewish Democratic Council, INDN Network and the Secretary of State Project...and Democracy Bonds when Dean introduced them.

And although I used to focus extensively on the DSCC and DCCC, I have not donated to them since the Democratic capitulaton on Bush's Iraq war. If I ever saw Congress really go gangbusters in enacting good progressive legislation, I would happily donate to the DSCC and DCCC again. That has yet to happen even with a Democratic President. And the Congressional Democrats still disappoint on key issues, though I still feel far better with Dems in control than with Repubs looting our country.

So now I am backing off from Democracy Bonds as well.

Right here, right now we have a perfect chance to get healthcare right. And if it is messed up it will be the DEMOCRATS who mess it up. And many of the Democrats who are threatening to mess it up are ones I spent a great deal of time and money electing.

Let's first consider our healthcare system. America has possibly the MOST expensive healthcare system in the world. This means you and I pay more for our healthcare than almost anyone in the world, when we take into account both our personal payments and our taxes.

But we do NOT get the best outcomes from our healthcare. The best outcomes are in places like Scandinavia, UK, Canada and the Netherlands. And they pay less than we do even when their taxes are taken into account. America's health outcomes do not macth up with these nations. Depending on the measure you look at, we measure up to places like Slovenia, Portugal, Albania, Khazakstan...and Cuba and North Korea. Here are the details:

Let's actually look at how the American business model for healthcare measures up to the more socialized systems. I have written about this before and I admit my figures are still from 2005. But here is how we measure up using some standard measures of national health (more details in the linked article):

The US ranks 29th for healthy life expectancy. That is right between Slovenia and Portugal. Keep in mind, America is a far wealthier nation than EITHER Slovenia or Portugal, yet our healthy life expectancy is only 69.3 years. Slovenia beats the US slightly with 69.5. UK, with a more socialized system, ranks 24th. Netherlands with a more socialized system ranks 18th. Canada, the system Republicans most like to denigrate when nationalized health care is suggested, ranks 11th. Sweden, which is almost synonymous with socialized health care, ranks 3rd with 73.3 years. We are beaten by nations with much lower levels of wealth (like Slovenia and Italy and Greece).

How about the probability of not reaching 60 years old? In the US there is a 12.8% chance of not reaching 60 years old. That is slightly better than Portugal and slightly worse than Albania. Again, we are far wealthier than Portugal or, for god's sake, Albania, but that is where we rank. I have a co-worker from Bulgaria (actually just moving on to a post-doc from being an excellent grad student). His stories as a Bulgarian who once visited Albania make Albania sound pretty damned awful. Yet that is where we rank with our healthcare system. In "socialist" Sweden, a person has only an 8% chance of not reaching 60 years of age. Canada, the UK and the Netherlands all rank better than us on this measure as well.

How about the probability dying before 5 years old (female): United States: 8 per 1000 people. Interestingly, that is identical to the rate for Cuba. Yes...we are on par with CUBA! Sweden, again, out does us, with 3 per 1000 people. Canada is in between with 5 per 1000 people.

How about respiratory disease child death rate: we are at 40.43...similar to Syria, the Philippines, Armenia, North Korea (yes, NORTH Korea), and Khazakstan. Canada is at 0.62, Japan at 1.52, Netherlands at 0.88, Sweden at 1.03 and United Kingdom at 1.78. Yeah, our children are about 40 times MORE likely to die from respiratory diseas than kids from Sweden, Netherlands, etc. And almost 80 times more likely to die from respiratory diesease than Canadian kids. Yet we pay more for healthcare than ANY of these nations.

Intestinal diseases death rate: United States is at 7.35%, right between Tunisia and Bosnia and Herzegovina. Canada is at 0.3%, Netherlands at 0.28%, Sweden at 0.39%...interestingly Poland and Greece do best. Not sure why, but Americans are still not getting our money's worth!

It goes on. I am not saying our health care is the worst in the world. Far from it. But when our peers for healthcare are Bosnia, Albania, North Korea and Cuba, perhaps it is time America starts to emulate those at the top: Canada, Sweden, Netherlands, UK, Canada...all those "socialized" systems.

Also keep in mind that Americans SPEND more on health care than most of the nations mentioned that outperform us. We pay more for a worse outcome. That is, by any business model definition, failure. Is that how we want to approach education as well? And I haven't even addressed the inequities in our system, another major flaw.

Now this is the CURRENT situation: high costs for mediocre outcomes. The time for a change came long ago. But Republicans and the wimpier Democrats have fought against the change we need and instead prefer to continue our system of HIGHEST costs for MEDIOCRE outcomes. It is stupid that we continue this situation.

I expect that kind of stupidity from Republicans whose stupidity has become legendary. But I expect better from Democrats.

Right now Republicans are irrelavent in the debate about reform of healthcare. They are so unpopular they should not be a factor in our calculations. So right now it is key DEMOCRATS who are blocking healthcare reform that would change our current highly expensive, mediocre system into a slighly less but still expensive, but far better system.

And some of those obstructionist Democrats would rather go on vacation than fix this problem. I cannot give blanket donations to a party that thinks their vacations are more important than healthcare.

Don't get me wrong...I will still more or less donate the same amount of money. But it will not be to the DNC or DSCC or DCCC but rather to Democratic organizations or candidates who SPECIFICALLY are fighting for what I believe in. I have been supporting Democrats in a more general way for more than a decade now. And if we still get this vacation BULLSHIT, I think my strategy has been misguided. And maybe I have to focus not on the PARTY, but on specific candidates and specific organizations that I know are doing the right thing.

I am not and never have been a purist. I even like some Blue Dogs (the Sanchez sisters for example). But sometimes I just want a return on my investment. And donating to the party in general is not getting me that return. So, like any investment, I have to reconsider my strategy. And my hope is that the Congressional Democrats will eventually reconsider THEIR strategy and recognize that progressive reforms are what will win elections. But until then, I will be reallocating my resources from the national party to far more specific efforts.